The Real Reasons for the Obesity Epidemic

Take a look around and it’s quickly obvious that too many of us weigh too much. Being obese may mean getting turned away from an amusement park ride or buying an extra seat on a plane, but perhaps more important, it endangers your health: Obesity is a risk factor for four of the six leading causes of death in the U.S.

But what’s really alarming is that it’s no longer an anomaly. Between 1960 and 1980, the U.S. obesity rate held steady at 15 percent—but since then the numbers have spiked. Some studies show that if this trend continues, over 40 percent of us will be obese by 2018. The question is, why?

“We’re not just turning into a nation of people with slow metabolisms,” says Lawrence Cheskin, MD, FACP, director of the Johns Hopkins Weight Management Center. Plenty of activists blame the food industry; unhealthy options are all around us and cheaper than ever. Other experts point to broader causes, from our sedentary lifestyles to how we think about food.

“However you look at it, we’ve created a perfect storm of bad influences,” says David Ludwig, MD, PhD, director of the Optimal Weight for Life Program at Children’s Hospital in Boston and author of Ending the Food Fight.

Luckily, as researchers uncover more and more about what these factors are and how they work together, they’re developing powerful strategies to counteract what’s contributing to our growing waistlines. Read on to find out how you can not only beat the scale but also help America beat the obesity epidemic.

The Problem: We Eat More Than We BurnOne thing we know for sure: If you consume more calories than you burn off, you’re going to gain weight. “Time was, people would come home from a long day of work having burned through a lot of calories, be it through manual labor or even just getting from one place to another,” says Dr. Cheskin. “Now, we’re mostly coming back from sitting at a desk in an office, having done things like drive a car and travel by elevator. We’re moving less, but still eating big meals.”

What You Can Do: Make Your Everyday Life More Active Remember that every little thing you do, from tapping your feet to taking the stairs instead of the elevator, burns calories, says David Edelson, MD, FACP.

Researchers believe that when we don’t move for hours on end, our whole metabolism slows down, so even a little motion (like walking to the water cooler) can counteract the effect. Along the same lines, there’s data showing that people who are natural fidgeters burn more calories throughout the day.

To maintain a healthy weight, experts recommend getting at least 30 minutes of moderate-intensity exercise (think brisk walking) at least five days a week. But be aware: When you first become more active, you may feel hungrier, because your body is programmed to want to store energy. Account for this (and keep yourself from raiding the cookie jar) by planning healthy, small pre- and post-workout snacks, and figuring them into your overall daily caloric intake.

The Problem: We’re Easily InfluencedObesity may not be a virus in the traditional sense, but, according to a landmark study in The New England Journal of Medicine, it can act like one by spreading through social circles. So if your friends and family are overweight, you’re susceptible as well. “We’re biologically programmed to take cues from our peers,” says Emily Levitan, ScD, assistant professor of public health at the University of Alabama at Birmingham. Some studies show that women will eat as much as 300 calories more when dining with their girlfriends.

The phenomenon doesn’t end with our peer group. A recent study from UCLA uncovered a surprising twist in the TV/obesity connection. They found that the more commercials children saw, the heavier they were (watching commercial-free programming had no impact on weight). Seeing people eat huge amounts of, say, sugary cereals onscreen may have the same kind of effect as watching our friends dig into giant portions. An ad for food is also a double whammy: We’re being given the visual stimulus to eat and the time to go get food.

What You Can Do: Choose (and Be) Good Role ModelsAccording to Dr. Ludwig’s research, entire families do indeed lose weight when they watch less TV. They also shed pounds when parents eat healthy (the kids mimic them). And countless studies have pointed to the effectiveness of losing weight as part of a group, or even blogging or tweeting about your diet. Feeling accountable to the people who are giving you support makes a big difference in losing.

Thinking about how your habits influence others also makes a difference. “When we alter our habits altruistically—to help our kids, for example—it’s easier to do,” Dr. Ludwig says. And a recent Stanford study showed that students who started eating more healthfully to help the environment (cutting down on meat to reduce their carbon footprint, for example) fared much better than those who did it just for themselves.

The Problem: Food is Cheaper Than Ever, So We’re Eating More of ItLack of activity, peer pressure— neither of these things would have this seismic impact were it not for one thing: Food is cheap. “In 1960, many people were spending as much as 24 percent of their income on food. When it’s that costly, you’re careful about what you buy. Today, many people are spending as little as 6 percent because food has become incredibly inexpensive,” says Brian Wansink, PhD, author of Mindless Eating and director of the Cornell Food and Brand Lab. In other words, as the cost of food has plummeted, so has the way we value it. We eat more and are less selective about our choices.

What You Can Do: Scale Way Back on PortionsAfter examining every edition of Joy of Cooking, Dr. Wansink determined that calories per serving have increased by an average of 35 percent since 1936, when the book was first commercially published. Restaurant portions are believed to have grown by about the same amount. Knowing this is a powerful tool. First, you need to readjust your eye to what healthy portions look like. (Go to womansday.com/cheat for our cheat sheet.) Another eat-less tactic: At home, try eating your meals on smaller plates—a salad plate, for example. Studies show that when people use smaller dishes, they take smaller servings and eat less. When you order an entrée at a restaurant, split it in half. Or get an appetizer instead. Slowly, your stomach will get used to the smaller portions and you’ll feel full on less.

The Problem: Our Foods are Filled with High-Calorie, Hunger-Driving IngredientsThere is, of course, another part to the cheap-food equation. “Our diet has been invaded by high-calorie, poor-quality commodities,” says Dr. Ludwig. “Wheat, soybeans and especially corn have been subsidized by the government—so there’s an abundance of simple carbs, unhealthy oils, and of course high-fructose corn syrup floating around.”

When certain ingredients started flooding the market at cheap prices, food companies found ways to use them to replace more expensive options. High-fructose corn syrup (HFCS), for example, costs so little that producers will often add liberal amounts of it to foods that, in the past, would have gotten a bare minimum of real sugar. Today you’ll find HFCS (and the extra calories it brings) in everything from bread to chicken nuggets. The same thing is happening with soybean oil.

The excess calories and fat these ingredients add is only part of the problem. “Sugars, fats and salt— all the things you get a lot of in packaged foods—don’t just taste good; they’re believed to drive appetite in a way that’s almost primitive,” says Dr. Levitan. “In previous generations, fat, sugar and salt were rare. So we have a biological drive to binge on them when we get the chance.” In fact, research supported by the National Institute on Drug Abuse has found similarities between the neural mechanisms underlying compulsive eating and cocaine addiction: People get a taste of these sweeteners and fats and have trouble stopping.

What You Can Do: Satisfy Your Hunger with Nutrient-Rich Whole FoodsMinimize the amount of packaged foods you eat, and when you do choose them, stick with foods that have as short an ingredients list as possible. More ingredients almost always means more processed— particularly if you can’t pronounce the names. Not only are packaged foods full of unnecessary additives, they also have few, if any, nutrients. The more a food is refined, the more nutrients it loses.

Research is showing that when we eat empty-calorie foods that don’t provide adequate vitamins and minerals, our satiety signals don’t get activated—so we keep eating more. The flip side: Fill your diet with nutritious food, and you’ll naturally eat less. Want proof? One Chinese study found that women who were given a daily pill that (unbeknownst to them) contained essential vitamins and minerals ate fewer calories and lost more weight than those who got a placebo.

The Problem: We Over-DietFour out of five American dieters regain weight they lose, a fact that’s got experts reevaluating our approach to curbing how much we eat. “You could liken traditional diets to telling people to think about breathing; as soon as you do that, the process feels unnatural and hard to do,” says Dr. Edelson. Think about it: Most of our strategies have involved some kind of counterproductive deprivation.

In the 1980s, for example, it was all lowfat and low-cholesterol. We later learned that cholesterol-rich foods like eggs and shellfish have a minimal effect on cholesterol in the body. However, huge amounts of pasta and similar carbs—what people were eating to compensate for the fat—actually make the liver produce large amounts of triglycerides and excess cholesterol. Similarly, snacking was, for generations, a diet “don’t,” but we now know that long stretches of time between meals cause the body to go into starvation mode, hoarding fat and calories.

What You Can Do: Find a Healthy Way of Eating That Works for YouMost people think of dieting as temporary, says Dr. Wansink. “But we need rules we can stick to for life or we’ll cheat or work around them.” The one style of eating that time and again results in healthy body weight is a plant-based Mediterranean one, rich in healthy fats like those from avocados, nut and olive oils, fruits and vegetables, whole grains, nuts and lean proteins. Globally, countries whose populations eat this way have lower rates of obesity and heart disease than other parts of the world. And just this past spring, the Journal of Women’s Health reported that 80 percent of American women who used this approach lost more than 5 percent of their weight compared with 31 percent of women following a lowfat diet. Experts believe that the balanced nutrition it provides satisfies our system so we’re not left with such strong cravings.

The Problem: Eating When We’re Stressed, Depressed or on the Go Has Become the Norm“When we’re stressed, we turn to food to feel better, which is a double whammy because the physical effects of stress, such as increased levels of cortisol, tend to cause weight gain,” says Dr. Edelson. Perhaps, adds Dr. Cheskin, this is because as a society, the way we eat these days is quite different from the way most of us did growing up. “We eat more frequently by ourselves now, whereas before, meals were a structured occasion.” We still associate food with love, safety, and comfort—but believe it or not, recent research shows that just 38 percent of Americans eat dinner with their families more than three times a week.

What You Can Do: Put Some Time and Effort Into Eating and Tune in to Your HungerIt takes about 20 minutes for the “I’m full” signal to get from the stomach to the brain. During a sit-down meal, where the chewing is interrupted by conversation (and we’re ideally surrounded by others who are eating healthfully), that’s plenty of time for our brains to get the message so we stop eating. But alone, on the go or in front of the TV, it’s all too easy to polish off an entire bowl of mac and cheese before that message has time to get where it’s going. And when we’re stressed or depressed or anxious, that’s exactly what many of us are likely to do. Experts estimate that 75 percent of overeating is caused by emotions. And data from the Eating Disorders Program at the University of North Carolina found that stress, loneliness, anxiety, anger, guilt, sadness, even boredom are all connected to overeating.

“We’re all in this obesity problem together,” says Dr. Ludwig. “The best thing you can do is get together and cook with your loved ones. Preparing meals together not only lowers the cost, it also turns food back into something special and worth savoring slowly.”

Comments

and lately, we are learning that lack of sleep totally messes up the other aspects of the obesity triggers ...
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7WORSHIPS

Informative article - it appears we all now know the reasons for the growing obesity epidemic. Putting all this information into action to change long standing lifestyle practices is the challenge. Articles like this help keep us motivated to change.
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JULIE_ED

I agree with CECE0330. Its multiple factors affecting the outcomes that contribute to unhealthy lifestyles. Our bad habits are learned behaviors that through education and careful consideration and hardwork can become reversed. But with anything you need to accept it, commit and start the change process. You may not be able to change the fact you work fulltime but you do have the choice to carefully select healthier foods. Yes healthier food may cost more but there are ways around this. It's about being a savy shopper, planning your meals ahead and making a commitment to yourself and your family. Commit because you are worth it!
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No one mentioned that, healthy food may be the best for us, but, when someone overeats, they don't reach for 4 lbs. of broccoli for a reason, I don't care what spice you put on it!! Our family eats the healthy food because we have to, but takes a day off here and there in order to have some treats. It will take another generation to get over the idea that eating nothing but healthy food is not some sort of punishment. Our culture has taught us that, look at what we consider celebratory foods now. Salad ain't one of those!!! Not yet, anyway. Tradition is hard to change.
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I think the combo of everything mentioned in the article; but more than anything the sheer convenience of living vs. 10-20-30 or more years ago. Because more women than ever before are in the workforce, often in non-physical jobs, we turn to dinners that are convenient not out of laziness, but simple lack of time. I get home from work at 5:45; my kids are ready for dinner at 5:46, so I need to whip together something fast, and that usually includes prepackaged items. Balancing kids, work, home is TOUGH. My kids are fortunately at an age where I can leave them for a few hours a week without a lot of guilt to work out-or bring them to the Y with me. But I know a lot of people who are single moms, and yeah, everyone can exercise somewhere, somehow, but living in a climate where it's only nice outside 6 months out of the year, not having a babysitter to care for young ones, and not being able to afford gym membership go a long way to prevent people from getting the exercise they need. Again, there ARE things everyone can do, but I remember all too well when I had my youngest waking me up at 5am, and my oldest not going to bed until 9pm. If they were awake, they were on me like white on rice. And by the time 9pm rolled around, I was simply too tired to even consider working out.

The flourish of subsidized, high-calorie additives to the gazillionty-seven products on the market is a gripe I've had for several years now. It dovetails with the point that is made about food being cheaper and more plentiful: The cheaper, more plentiful foods are the ones pumped up with the subsidized, high-calorie additives.

If the whole, healthy foods were the ones that were subsidized and therefore cheap and plentiful, people would be buying far more of them than what they do.
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I'm glad that Dr. Ludwig published the fact that..."They also shed pounds when parents eat healthy (the kids mimic them)." Of course kids mimic parents. And I'm very glad that the emphasis on the article is basically that WE have to take control of our lives. While there are many factors that contribute to obesity, losing weight is basically a personal responsibility. Some people need help after they've made the decision, and that's fine. But the decision itself to lose weight must begin with the individual. And yes, thee are definitely mental health issues that play a role. Don't blame the food industry, no one forces a person to buy junk food.
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My kids were looking at my high school annual from the early 70's. The first thing they noticed was how everyone was of normal weight, no one super over weight and no one super skinny (as compared to their high school annuals). I told them we didn't have McDonald's, and drive thru's on every corner. We had to walk to school, if we lived within a mile of school, so we always walked. We had physical education 5 days a week, not just once in a while. In grade school we were weighed whenever we got a report card. I actually think the nurse was checking for under nourished children and rickets instead of obesity, but my parents knew my weight from my report card! I never ate out in a restaurant until I was in high school and then we ate out only twice . . . my entire high school years. My husband was the same way. I didn't grow up in some 3rd world country either. I grew up in Sacramento, California! My parents were both teachers, but my mom made our lunches everyday, my dad made breakfast every morning and they both made dinner every night! That was the difference.
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When I was growing up in the ''50's and '60's I didn't know anyone who was obese. I was 5'4" and 113# in high school and thought nothing of it. We ate three meals per day AT THE TABLE as we weren't allowed to take food out of the kitchen. If we came home from school and my mother gave us a "snack" we sat at the table and had a glass of milk or kool-ade and a cookie or two. SHE served it to us. I think today kids just eat all the time, and don't eat balanced meals. We were NOT allowed in the kitchen to get into the refrigerator between meals. We didn't have junk food. If we went to a Fair or Picnic, then we skipped the meal at home. People just eat way to often now and way to much.
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KARATE_KID

I'm glad there is more of an understanding that obesity is a complex issue and simplistic solutions don't work. When I was a kid, we didn't have fast food everywhere, we didn't have computers, we didn't even have a TV until I was 8 and then I was allowed to watch 1 hour a week. We lived on the 5th floor with no elevator and I spent every day playing outside. Guess what - I was still a fat kid.
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This article makes several really good points. The one that I most strongly identify with is the processed food. My brother works in US Foreign Aid, which means that he's lived in some amazing places (which incidentally also start with the letter "U', Ukraine, Uzbekistan, Uganda). Even though I tend to eat and drink like I'm on vacation whenever I go see him, I always lose weight. I can't attribute my weight loss to activity either, because I have a really active lifestyle at home. There's a reason why they call the Standard American Diet S.A.D.
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I agree with this article except for the cost of food. Incredibly inexpensive?? Where? Where I live food is incredibly expensive, and when you try to eat healthy, natural or organic foods, the cost is mind boggling. I guess junk food can be cheap, and that certainly is the kind that will make for the most obesity problems, but food in general is not cheap!
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I agree - except for the cost of food being lower. While unhealthy options most certainly are cheap, it costs a small fortune to feed a family of 4 healthy, nutritious and fresh food. In any given month, 15%-18% of our family's income is spent on food alone. And that's shopping sales and using coupons! If healthy options were cheaper, more people would consume them.
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I also agree with most of what is said but I am a mother of five kids. We spend a lot of money on groceries, about 500 dollars a month maybe more. We make kids lunches, snacks for after school, to make dinner, and then there are things that I need so I can eat healthier. So it actually adds up to a car payment. And the healthier foods are more expensive then the non-healthy foods. I do buy the big bags of apples and oranges and bananas and these are added to the kids lunches. I have to buy twice as much because there are so many of us. Everything I buy has to be doubled because my kids go through a bag of apples in 2 or 3 days. If I could just come up with an easier way of saving money on groceries without having to cut coupons would be great. But coupons are mostly for name brand product when i can buy the off-brand for the same price or cheaper. And not many coupons are geared to fruits and veggies.
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There really is no one single cause for the increase in obesity in America. I think it's a combination of different problems.

First off, the rise in obesity also happens to correspond with the increase in the availability of fast food. When I was young (back in the Dark Ages), there wasn't a McDonalds, Burger King, Wendy's, Taco Bell, etc... practically on every corner. When I was young, going to McDonalds was a treat because there wasn't one near me and we had to make an effort to go there.

Two, there has been an increase in portion sizes. When I was young, a small fries was just that, a small fry. No supersizing ! no buy one get one free. Portions were reasonable, not oversized or supersized.

Three, the food industry has increased the use of sugar, fat and fat in their products as a way to enhance the flavor of the food. Meaning, the better something tastes, the more of the something we'll buy. The amount of sugar Americans eat is pretty insane.

Four, lack of exercise. Back in the Dark Ages, before the invention of video games, I used to play outside. So, I did get more physical activity than your typical American kid these days.

Five, fewer people actually sit as a family to eat a home cooked meal. Everyone has their own schedule and as a result, they are eating quickie meals at all different times. Fast food is convenient. Why cook when you can order a pizza in 15 minutes or less ?

There are a ton more reasons that all add up to an increase in the American waistline.

What to do ? People have to be more mindful of their portion sizes and they must start getting some regular exercise. And well, it wouldn't hurt if people started spending more time sitting and eating with each other as a family.

I honestly feel that each individual is responsible for their own consumption of food and beverages that we put in our body each day. I was guilty of this too, and at times I still am. I will get stressed about life and then I want to eat! We have got to find more positive ways to handle what is bothering us. It may be that we need to keep a journal with us at all times, so when we feel the urge to replace our emotions with food, we can write all these feelings down in a journal! It may be that you need a friend to be accountable too each and every day until it feels natural for you to control those emotions. Also, never feel like you can't get up off the couch and put your body in motion. Lot's of people feel like you have to work out for an hour at a time each and every day to get any kind of weight loss. That is rediculous! I have been on SP for a little over a year now, and I have maintained the weight just fine by doing 30-45 minute work outs every day. So you see you don't have to burn yourself out to get the benefits, but in the long run if you put these principles into practice, you will find you won't have to be telling yourself, I am obese, I need to loose weight. I realize some people have medical problems which make it hard for them to loose weight, and I think then that medical advice should be sought to help those individuals. I have even had to ask my doctor for help! There is nothing wrong with that!
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GMAGEE

I think it's all of these factors combined. In the not so distant past, people used to walk to their jobs - or walk to public transportation to get to their jobs - and they were stressed out in different ways that didn't seem to direct them to eat. Food wasn't as available or varied - especially if you had to grow it or hunt it yourself - and processed food didn't have as many additives as today. Peer or TV influence is a big factor too. Super Bowl Sunday was as much about the party snacks as it was about the football, no?
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One of the biggest factors for me was all the erroneous information blasted at us from the diet industry. They mislead and out right lie to get our money. Offering "miracle" pills and bars and well crap. We need to be better educated on nutrition, period !
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The size and change in makeup of grocery stores mimics our 'growth.' The "inside aisles" where processed foods lurk have expanded (in my distant youth, there were, maybe, two sides of an aisle for anything more complicated than canned or ingredients--and that included cereals. Now, those foods make up 30% of a store, with soda-type products taking up another 5-10%. And those processed foods that tout themselves as 'healthy' are making it hard for a lot of people to know how to eat really healthily because of the advertising.

Portion control is probably the biggest issue, at home and out. Lack of exercise--as part of our lives, not an 'add-on' to be done or not as the day permits--is also missing. For the first time in my life I live too far from work to walk (17 miles each way) and really miss the built-in nature of my exercise. It's changed my whole relationship to it.
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Great article. The approaches are tried and true. I've maintained a weight loss of 75+ pounds for more than 22 years. The month I hit goal I quit smoking (2+ packs per day) and didn't gain so much as a pound during that process. Throughout the weight loss process and even still, I educate myself on nutrition and the dance we do with emotions and eating. Lack of education, emotional triggers, greed and lack of self-control are the main reasons for obesity.
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Over all, I think there are three major problems contributing to the obesity problem all of which have bben captured here: 1) portion size (go to a restaurant and ask for a small serving - they get insulted) 2) high fat content in processed foods 3) lack of activity (we keep telling children to sit still rather than encouraging them to move)

I think we need to look at how we view ourselves and our neighbours, encourage our neighbours to get out at walk with us and encourage our children to move more. Report

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